Prescription Drug Monitoring

Several hundred million doses of prescription drugs like morphine and codeine are diverted to illicit use each year, but several states have developed monitoring programs that seem to be effective in curbing the illegal practice. Drug diversions can involve the illegal sale of prescriptions by physicians, illegal dispensing by pharmacists, or "doctor shopping" by individuals who visit many doctors to obtain prescriptions. GAO reviewed the 10 existing state prescription drug monitoring programs and found that they save investigators' time and improve their productivity by providing information that allows them to identify potential cases of drug diversions. Prescription drug monitoring programs were not meant to measure their effect on reducing health care costs; however, two of the states with these programs have cut Medicaid prescription costs by an estimated $27 million over two years and $440,000 over one year, respectively. The other eight states were unable to estimate Medicaid savings. Claims by medical, pharmaceutical, and patient groups that prescription drug monitoring programs have harmed a doctor's ability to practice medicine or have compromised patient care or confidentiality have not been substantiated.

GAO found that: (1) prescription drug monitoring programs save investigators time, improve productivity, and allow identification of potential cases of drug diversion; (2) 5 of 10 states showed a reduction in the number of prescriptions due to reduced diversion or changes in physician prescribing practices; (3) states claim that prescription drug monitoring programs increase the efficiency of law enforcement operations and result in greater disciplinary action; (4) New York and Michigan estimated Medicaid cost savings at $27 million and $440,000, respectively, but a lack of complete data hampers Medicaid savings estimates and program tracking; (5) opponents believe that programs result in less effective drug prescription, compromise patient confidentiality, and change physicians' prescribing practices; and (6) three states utilize electronic transmission systems, which are viewed as less burdensome and less intrusive than multi-copy prescription form programs.